[Arrhythmia in patients with ischemic heart disease and indications for surgical treatment].

Abstract

The authors analysed 171 patients with ischemic heart disease (IHD) and life-threatening and non-threatening arrhythmias before and after surgical treatment. The control group was composed of 34 patients with IHD (of a similar severity of the principle disease) but without arrhythmias. Life-threatening arrhythmias of the third arrhythmic group persisted even after effective revascularization of the myocardium and resection of the aneurysm. To reveal the zones of elective instability in this group of patients preoperative electrophysiological examination must be conducted with programmed stimulation of the heart for subsequent simultaneous correction of coronary circulation and the conducting system of the heart. Inoperable patients suffering from IHD with threatening arrhythmias (according to coronary pathology) are considered, in the absence of contraindications on the part of the viscera, to be potential recipients for heart transplantation. Patients with IHD and non-threatening arrhythmias should be kept under observation and given corrective drug therapy. The question concerning their operative treatment is decided upon according to the standard indications for IHD.